Some couples are unable to conceive children despite wanting to do so. However with technological and medical breakthrough that happened in the past few decades, couples who have issues conceiving children can now attempt modern conceiving methods with higher chance of success. In vitro fertilization is one of those modern reproductive methods that couples can try. This technology is now available worldwide.
What is In Vitro Fertilization?
In vitro fertilization or also known as IVF is a procedure of procreation in which female’s egg is fertilized by male’s sperm outside the body, usually in vitro (in a glass). The procedure for baby human was introduced back in 1978. It is considered the most effective (though also more complex) assisted reproductive technology. The success rate of this technology, especially for women under 35 years old, reaches 40%.
In vitro fertilization certainly helps couples who wish to have their own children but unable to do so for certain causes. Some mothers have issues with their reproductive system such as damage in fallopian tube, endometriosis, and premature ovarian failure that hinder them from conceiving. Other times, fathers have issues with their sperm production. They may produce low amount of sperms or have sperms with abnormal morphology and poor mobility. Aspiring parents who are undergoing medical treatment such as chemotherapy may also reserve their egg and sperm cells for future use.
As stated previously, although in vitro fertilization often yields favorable results, it is a very complex process. Here are several stages of this procedure.
1. Fertility Medication
Mother will be prescribed fertility medication in order to increase egg production. Multiple eggs are preferred since some might not develop after being retrieved. They will receive medication for ovarian stimulation, for egg cell maturation, for preventing early ovulation, and for preparing uterus lining.
2. Egg Cells Retrieval
Eggs are extricated through a minor surgery with the guidance of ultrasound. Mother may experience discomfort during the surgery.
3. Sperm Cells Retrieval
Father is expected to produce sample of sperms to proceed with the procedure. Father’s sperm needs to be analyzed beforehand to ensure success.
It can occur through insemination or intracytoplasmic sperm injection (ICSI). Fertilization through insemination happens by combining mature eggs with healthy sperms then incubating them overnight. Meanwhile fertilization through ICSI occurs by injecting healthy sperm cell into every mature egg.
5. Embryo Transfer
Last stage is to transfer formed embryo to the uterus of mother or another woman (if it is a surrogacy case). It usually happens two to six days after fertilization stage.
Even before undergoing in vitro fertilization procedure, aspiring parents need to participate in some screenings to ensure success. Here are some tests that couples need to go through before proceeding.
1. Ovarian Reserve
This test is used to figure out the number and quality of egg cells produced by mother. Test usually includes concentration of estrogen, antimullerian, and FSH in the blood during early days of menstrual cycle as well as ultrasound. It will give the information of how mother’s ovary might react to fertility medication.
2. Screening for Infectious Diseases
Mother and father will be screened for infectious diseases such as HIV, hepatitis, and Chlamydia. In vitro fertilization will be reconsidered if any of those diseases found. It is also protecting mother or surrogate from contracting same disease.
3. Examination of Uterine Cavity
This process can involve sonohysterography or hysteroscopy. In sonohysterography, certain fluid will be infused from cervix to mother’s uterus and then ultrasound will capture image of uterine cavity. Meanwhile hysteroscopy is done by inserting hysteroscope (thin and flexible telescope) from vagina, through cervix, then into uterus to get the image of uterine cavity.
4. Practice for Embryo Transfer
Some doctors choose to practice embryo transfer before the procedure. It is done to check depth of mother’s uterine cavity as well as figuring out which technique would be the most successful in placing embryo within mother’s uterus.
5. Analysis of Seminal Fluid
This analysis is done right before the procedure. Seminal fluid is pivotal in determining male infertility. By analyzing seminal fluid, doctors can evaluate sperm quantity, normal morphology or form, and motility.
Success rate of in vitro fertilization is determined by number of factors. Maternal age is one of the biggest success determinants. Mothers under 35 generally have better chance in conceiving through this method than the older ones. Mothers’ reproductive history is also pivotal to the success of this procedure. Those who have given birth have higher probability in pregnancy through this method to those who have not. If woman’s infertility is caused by lower eggs supply (e.g.: because of endometriosis), they are less likely to succeed using this method than the one who has inexplicable reason for infertility. Parents’ lifestyles such as smoking, obesity, and drug consumption are also important in determining the success of this assisted reproductive method.
Factors to Consider Before Conducting In Vitro Fertilization
As with other medical procedures, in vitro fertilization also possesses some risks. It can elevate the risk of multiple births when more than one developed embryos are planted within uterus. While this result may be favorable to some parents, it may not be the case to some others. Research has also found that babies that are conceived through this procedure are more likely to be born prematurely or with low weight. During egg retrieval stage, mothers may also encounter risk of bleeding and infection because of needle used in the process. Ovarian hyper-stimulation syndrome (OHSS) because of injected fertility medication, while rare, can also occur.
There are also other risks not directly related to parents’ reproductive system. The entire procedure is complicated and often causes physical and mental exhaustion to aspiring parents. Stress from undergoing this procedure may affect parents’ other life aspects. This procedure is also costly, ranges from $12,000 to $17,000 at the very least. Many insurance plans have not yet covered this fertility procedure.
With technological and medical development, people who have trouble in conceiving children can now choose wide array of fertility treatments. By learning the process and possible risks of in vitro fertilization, parents hopefully will be able to make informed decision.